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BACKGROUND: Asthma is a respiratory chronic disorder characterized for the inflammation of the airways. In 2013, approximately 10% of adults lived with current asthma in Puerto Rico. Since asthma is a condition that cannot be cured, it is important to monitor asthma control in the population to ensure the allocation of necessary resources for adequate education and management. The purpose of this study is to describe asthma control in adults in Puerto Rico. Also, the study aims to identify factors associated with uncontrolled asthma.
METHODS: Data used for this study was obtained from the 2011-2012 Asthma Call-Back (ACB) survey, conducted by the Puerto Rico Behavioral Risk Factor Surveillance System (BRFSS). Self-reported asthma control status was constructed using an algorithm developed by the National Heart, Lung, and Blood Institute Expert Panel Report-3 (EPR-3). Asthma control prevalence was analyzed by sociodemographic and behavioral variables. A multivariate analysis was conducted using logistic regression to identify factors associated with uncontrolled asthma. Prevalence odds ratios (POR) and p-values (<0.05) were calculated to measure the magnitude and significance of the associations. Statistics were calculated using R version 3.1.2.
RESULTS: During 2011-2012, 47.6% of adults with asthma had their condition uncontrolled. Most of the adults with uncontrolled asthma were female (69%), had 35 to 64 years of age (57%), and had an annual household income less than $25,000 (86%). In the multivariate analysis, adults 35 years of age or older (POR35-64 = 4.5 and POR>64 = 3.6) unemployed (POR = 4.27), those who reported health-related cost barriers (POR = 1.76), and those who have not been educated in asthma management (POR = 1.99) had significantly higher odds of uncontrolled asthma (p < 0.05).
CONCLUSIONS: Asthma control is a public health issue that is usually studied in pediatric populations. This is the first population-based study that addresses asthma control in adults in Puerto Rico. This study presents information that can delineate public health efforts in developing policy to promote changes in the health care system to better assist adults with asthma. For this reason, it is imperative to continue monitoring population asthma control to identify disparities and populations at risk in order to reduce morbidity and mortality associated with asthma in Puerto Rico. In addition, BRFSS Asthma Call Back Survey can be a valuable tool to assess asthma control in other states and territories.